A wisdom tooth that has come through straight, bites against its opposite number and can be cleaned does not need removing. The ones that need to come out are those causing repeated infection, decay that cannot be restored, damage to the tooth in front, or pain that keeps returning. Removing a healthy, symptom-free wisdom tooth is not routinely recommended.
Why they cause trouble
Wisdom teeth arrive last, usually between seventeen and twenty-five, into whatever space is left. Often there is not enough, so they come through at an angle, only partly emerge, or stay buried.
A partly emerged wisdom tooth is the difficult case: a flap of gum sits over part of it, food and bacteria collect underneath, and no toothbrush reaches. That is the setup for pericoronitis — the swollen, painful gum around a wisdom tooth that tends to flare, settle, and flare again.
Reasons to remove one
- Repeated infection around a partly emerged tooth
- Decay in the wisdom tooth or in the tooth in front that cannot be restored
- Damage to the second molar from a tooth pressing into it
- A cyst forming around a buried tooth
- Pain that keeps returning rather than settling
Reasons to leave one alone
It is fully through, upright, biting against the tooth above or below, cleanable, and has never caused a problem. In that situation removal exposes you to the risks of surgery for no benefit.
What the procedure involves
An X-ray first, to see the shape of the roots and how close they lie to the nerve in the lower jaw. That relationship decides how the tooth is approached and is the single most important thing to know beforehand.
The area is numbed with local anaesthetic. A straightforward upper wisdom tooth may take a few minutes. A lower tooth lying at an angle usually needs a small incision, sometimes removing a little bone, and often sectioning the tooth so it can come out in pieces rather than forcing it whole. Sectioning is a sign of careful technique, not difficulty.
You will feel pressure. You should not feel pain. Say so if you do — more anaesthetic can be given.
Recovery, day by day
Swelling peaks around day two or three and then settles. Bruising is normal. Jaw stiffness for several days is normal.
Take painkillers before the anaesthetic wears off rather than waiting for pain to start. Cold compresses on the first day, then warm ones after forty-eight hours. Soft food, and avoid chewing on that side.
Do not rinse at all for the first twenty-four hours. After that, gentle warm salt-water rinses several times a day.
Dry socket, and how to avoid it
A blood clot forms in the socket and protects the bone underneath while it heals. If it is dislodged, the bone is exposed — that is dry socket, and it is a deep, throbbing ache that typically begins three to five days afterwards and is not relieved by ordinary painkillers.
The main things that dislodge a clot are smoking, drinking through a straw, vigorous rinsing and spitting. Avoiding those for the first few days is the most useful thing you can do.
If it happens, come back. It is treated by cleaning and dressing the socket, and the relief is usually rapid.
When to call us afterwards
Bleeding that does not stop after twenty minutes of firm pressure on a gauze pad, swelling that worsens after day three rather than improving, fever, or numbness of the lip or tongue that has not returned to normal.
Read more about Wisdom Tooth Removal on our website, or call +91 9585 360 320 to speak to us.
This article is general information, not a diagnosis. Every mouth differs — please see a dentist about your own symptoms. How we review our content
